Stege's Podiatric Topics


Proper footwear can reduce foot problems

From ancient Egypt, medieval times and down through the centuries, footwear has been designed to meet mankind's real and perceived needs -- protection, support, comfort, sturdiness, stylishness, and the rest.

Today, there are almost as many different kinds of footwear as pieces in a jigsaw puzzle, an almost endless variety of styles and materials -- you have a major dilemma when it's time to buy a pair of shoes. It can be minimized, however, if you concentrate on the health aspects of the modern shoe: well-fitting, well-made, and used properly, it has an inherent capacity to help reduce foot problems.

Your feet bear the tremendous pressures of daily living. An average day of walking brings a force equal to several hundred tons to bear on your feet. Your feet are subject to more injury than any other part of your body, thus highlighting the need to protect them with proper footwear.

Children, women, men, and athletes all have different shoe requirements, and such requirements will vary considerably across a wide range of activities.

Children's Shoes

When a child begins to walk, shoes generally are not necessary, Allowing an infant to go barefooted indoors, or to wear only a pair of socks, helps the foot grow normally and develop its musculature and strength, as well as the grasping ability of toes.

As children grow more active, and their feet develop, the need for shoes becomes apparent. It becomes necessary to change shoe sizes at a pace which frequently surprises and even dismays parents, to allow room for growth.

Though fit is the most important consideration, function is also pertinent. For youngsters who have reached the stage of walking stability, footwear with crepe or rubber soles helps cushion impact on growing feet better than the soles of dressier shoes with thinner soles.

Women's Shoes

Women, inhabiting the work force in greater numbers, inflict more punishment on their feet, in part from improper footwear they feel obliged to wear at work -- footwear which can bring about unnecessary foot problems.

Some women's foot problems result from high-heeled shoes (generally defined as pumps with heels of more than two inches). Doctors of podiatric medicine believe such heels are orthopedically unsound, and attribute medical, postural, and safety problems to their use.

To relieve the abusive effects of high heels, women can limit the time they wear them, alternating with good quality sneakers or flats for part of the day.

They can also vary heel height. For example, there are comfortable and attractive "walking" pumps (also called "comfort" or "performance" pumps) for work and social activities. These shoes blend fashion considerations and comfort, offering fashionable pumps with athletic shoe-derived construction, reinforced heels, and wider toe room.

Activity has a bearing on the considerations; wearing the right shoe for a particular activity is probably as important a factor in the choice of shoes as any.

Perhaps the best shoe for women, from an orthopedic viewpoint, is a walking shoe with laces (not a slip-on), a Vibram-type composition sole, and a relatively wider heel with a rigid and padded heel counter, no more than a half or three-quarters of an inch in height -- even though such a shoe may be scorned in fashion circles.

Men's Shoes

The best shoes for men are good quality oxfords, shoes ordinarily associated with wing-tip or cap designs. Also suitable are slip-ons, dressy loafers, and low, dress boots.

Men, as well as women, should buy shoes for work, leisure, and special activities -- match the shoe to the activity, in other words.

Male (and female) office workers should earmark three to five pairs of shoes for business hours -- general oxfords and loafers for men; pumps and oxfords for women. Cushioned-sole shoes which give good support are essential for those who spend most of their working days on their feet.

There is no question about the need for foot protection for those who work in heavy industry. Safety shoes and boots -- those that are waterproof or water-resistant, with insulated steel toe caps and soles of non-conducting materials -- help prevent injuries to the feet, and reduce the severity of injuries that do occur.

Shoes for Athletics

Different sports activities call for specific footwear to protect feet and ankles. Sports-specific athletic shoes are a wise investment for serious athletes, though perhaps a less critical consideration for the weekend or occasional athlete; nevertheless, it's a good idea to use the correct shoe for each sport. Probably a more important consideration is the condition of the shoe -- don't wear any sports shoes (or any shoes) beyond their useful life.

Podiatrists note that athletic footwear should be fitted to hold the foot in the position that's most natural to the movement involved.

For example, a running shoe is built to accommodate the impact that concentrates on the forefoot, while a tennis shoe is made to give relatively more support to the ankles, and permit sudden stops and turns. Because of the many intricate maneuvers involved in such events and the added strain they put on the feet, athletic shoes ought to be fitted for comfort and support with as much attention as dress shoes ordinarily get.

It is widely accepted that a regular regimen of walking is physically rewarding. Here again, footwear with proper support is most important. Choose a good quality, lightweight walking shoe with breathable upper materials, such as leather or nylon mesh. The heel counter should be firm, the heel positioned closer to the ground for walking stability. The front or forefoot area should have flexibility, and plenty of room for the toes to move around. Also important: cushioned heels and soles for resilience on hard surfaces and traction on slippery ones.

Buying Tips

Shoe Care

For longer service, keep shoes clean and in good repair. Avoid excessive wear on heels and soles. Give your shoes a chance to breathe by rotating their use. Don't ever wear hand-me-down shoes.

Seal of Acceptance

The American Podiatric Medical Association awards its Seal of Acceptance to a wide variety of shoes (and shoe-related products), which have been deemed to enhance a consistently applied program of daily foot care and regular professional treatment.

The intent of such endorsements is to make a significant contribution to the foot health and foot health education of the public.

Your Podiatrist Can Help

Doctors of podiatric medicine are health care professionals trained in the care of your feet. Whenever you have questions about selection of the right pair of shoes, or other aspects of foot health -- for you or other members of your family -- the DPM in your community is there to help you.

(c) Copyright 1996 - David C. Stege, DPM - All rights reserved.